Head Injury? Update and more questions, post #29/page 2

[Southernmiss]

Will you send your DS to school tomorrow? If it were me, (and I am usually the "rub some dirt on it" and keep going kind of mom) I think I'd see how he did at school tomorrow--if it makes him overly tired, or brings on headaches, etc. and then decide about taking or postponing midterms.

I do think I'd alert his teachers and the nurse and ask for notification if he seems "off" in any way while at school.

 

[Mickey'snewestfan]

Are neuropsychologists not covered by your insurance plan or was the particular place not in your network? Are any neuropsychologists in your network?

I don't think that neuropsychologists are covered at the same rate or in the same way, since they are considered "behavioral" issues rather than "medical". But I'm calling the insurance company tomorrow to be certain.

 

[Bluestars]

I don't think that neuropsychologists are covered at the same rate or in the same way, since they are considered "behavioral" issues rather than "medical". But I'm calling the insurance company tomorrow to be certain.

That's a good idea to call and ask. It could be that the particular one your son was being sent to isn't in your network. My insurance has a network too, which includes specialists. If the specialist isn't in the network, it's covered at 60% instead of 80% and there is no out-of-pocket maximum. Same with hospitals being in or out of the network.

If your insurance company has a website, you might be able to access the information there. You might also be able to see if there is a list of neuropsycologists in your network using the physician or facility search for whatever network you are in. With my insurance, I can do a physician and specialist search online.

It's also possible that behavioral is only covered at 50%. i'm not sure how my insurance company would classify that type of service. Calling is a good idea.

 

[LisaR]

I'm far from an expert on this, but I will say that the two people I know who had issues following head injuries had very obvious signs so it was clear that they needed help.

My nephew was thrown from one of those huge farm tractors. He had headaches, dizziness, and slurred speech from the first day.

My SIL (his mom) was thrown from a horse. About a week after, she was saying weird, off the wall comments and her writing was illegible.

Based on those two experiences, it seems to me like you would notice if your son needed further testing. I'm pretty sure if it was my kid, I'd just keep a very close eye on him for a few weeks and see if anything seems off. Go with what feels right to you.

 

[SueM in MN]

The clinic is part of one of the top children's hospitals in the nation. He's been seen there by many other specialists (all of whom were covered) and they've generally been good. I don't think they're taking advantage, but with a head injury I think they keep testing until the child is "cleared" meaning they're back to normal. Given that, they can't tell me how long.

I work in a hospital that has an outpatient concussion clinic.
I don't work directly with the clinic, but have seen presentations they have done and the son of a friend has gone to a conclusion clinic.
They continue to do follow up visits until the person gets to a particular point in recovery.
How people recover is very variable, so it is really hard to tell how long the follow up will need to be.

This is actually the clinic that does the neuro baseline for our high school. We'll see them this summer before he starts high school because he's a football player. Since he played youth football, I actually thought about asking if he could come in last summer instead, but I didn't. Now I'm regretting that.

I asked if he could see a neurologist instead of a neuropsychologist, because there are plenty of neurologists in network. The reply I got is that the neurologist would only look at the physical symptoms, but maybe I'll ask the ped. the same question.

The reply you got about neurologists and neuropsychologists is correct.
Neurologists look at physical symptoms and physical damage.
Neuropsychologists are experts at measurement of the function of the brain - things like cognitive testing, that Neurologists don't do.
Neurologists and Neuropsychologists work together in many clinics.

 

[Mickey'snewestfan]

I work in a hospital that has an outpatient concussion clinic.
I don't work directly with the clinic, but have seen presentations they have done and the son of a friend has gone to a conclusion clinic.
They continue to do follow up visits until the person gets to a particular point in recovery.
How people recover is very variable, so it is really hard to tell how long the follow up will need to be.

The reply you got about neurologists and neuropsychologists is correct.
Neurologists look at physical symptoms and physical damage.
Neuropsychologists are experts at measurement of the function of the brain - things like cognitive testing, that Neurologists don't do.
Neurologists and Neuropsychologists work together in many clinics.

Thanks Sue!

In the circumstances I describe, would you take him?

 

[horseshowmom]

If you wouldn't get the testing, would you ask for accommodations at school? Midterms begin on Friday. I already emailed his counselor asking if his Friday test could be pushed back so he's had 3 more days to recover and to review the stuff he missed. Does that make sense?

I probably would. I don't think that what you're asking is out of line, and he probably doesn't need to be stressing his brain at this point.

Will you send your DS to school tomorrow? If it were me, (and I am usually the "rub some dirt on it" and keep going kind of mom) I think I'd see how he did at school tomorrow--if it makes him overly tired, or brings on headaches, etc. and then decide about taking or postponing midterms.

I do think I'd alert his teachers and the nurse and ask for notification if he seems "off" in any way while at school.

I also agree with this about letting him go back tomorrow if he thinks he feels like it. If he seems to do well and really feels like he's up to exams, you might play it by ear. If one seems to wear him out, postpone the others. But I also don't think you're out of line for requesting that they be postponed.

 

[SueM in MN]

Thanks Sue!

In the circumstances I describe, would you take him?

I can't really give an opinion to you on that.
I would probably do it because in pretty cautious.

You could call the Pediatrician, explain insurance said they would not pay and see what they suggest. It could be that if the doctor writes the order a little differently, it would be covered. The doctors could also give you an opinion about how important it would be to do it, based in your child.

From what I know, it is important to know this injury is resolved before he does any activity that would be risky to cause another concussion.

 

[Mickey'snewestfan]

So, I called the pediatrician today. The nurse said I should probably take him, but she wasn't sure. I made an appointment for tomorrow a.m. for the Dr. to get his opinion.

I also called my insurance who gave me a list of Dr.'s who "do the same thing" who are covered. However, when I called them to schedule they were neurologists, not neuropsychologists. One was in the same office at the hospital as the concussion clinic, and the other was in private practice. The one in private practice said they could see him but they can't do "impact testing", it would just be looking at him, talking to him, looking for signs. I'm not convinced that's any more than what the pediatrician or E.R. doctor can do.

I should add that I had already asked the concussion clinic whether a neurologist would do, given that I know my insurance covers neurologists and they said no. Any thoughts?

 

[Southernmiss]

So, I called the pediatrician today. The nurse said I should probably take him, but she wasn't sure. I made an appointment for tomorrow a.m. for the Dr. to get his opinion.

I also called my insurance who gave me a list of Dr.'s who "do the same thing" who are covered. However, when I called them to schedule they were neurologists, not neuropsychologists. One was in the same office at the hospital as the concussion clinic, and the other was in private practice. The one in private practice said they could see him but they can't do "impact testing", it would just be looking at him, talking to him, looking for signs. I'm not convinced that's any more than what the pediatrician or E.R. doctor can do.

I should add that I had already asked the concussion clinic whether a neurologist would do, given that I know my insurance covers neurologists and they said no. Any thoughts?

I don't know the difference in a neurologist and neuropsychologist. The athletic trainer at DSs school recommended the NEUROLOGIST that he went to. That Dr. specialized in teens with head injuries and knew well what he was doing. So I really don't see the insistance on the neuropsychologist.

 

[debster812]

OP--DS got a concussion in Fall of 2011 playing soccer. (Going up for a header, opponent's elbow collided with DS's temple. At all our HS sporting events there is an EMT, Paramedic, or Licensed Athletic Trainer in attendance. The paramedic spent about 30 minutes with him on the sideline, and at the end of the game recommended we take him to the Dr. or the ER.

All the athletes at our school get a baseline ImPact test before they are allowed to compete, so we were very lucky in that we had a good, solid baseline. DS was diagnosed with a mild concussion, and was not allowed back to practice or games until he passed his follow up ImPact test. He could not take the follow up until he was symptom free.

It took 3 weeks before he was fully cleared and symptom free, and it took him about 4 months until his sleep patterns were fully back to normal.